314名泌尿外科医师腹腔镜模拟培训效果分析

目的:评价泌尿外科医师腹腔镜模拟培训效果。方法:2011年3月～2012年3月314名26～53岁泌尿外科医师参加腹腔镜模拟培训,在腹腔镜模拟机和训练箱进行腹腔镜手术基本技能培训前后进行问卷调查,并比较培训前后模拟机客观评分和综合评估量表(GRS)评分结果。结果:其中86名泌尿外科医师经3天腹腔镜模拟培训后,电钩练习时间、剪切时间、缝合打结(方结)时间较培训前明显缩短(P<0.01),电凝效率、GRS明显提高(P<0.01)。反馈调查结果显示279名(97.6%)受训者认为模拟培训对提高腹腔镜操作能力帮助明显或非常有帮助。结论:腹腔镜模拟培训可帮助泌尿外科医师提高腹腔镜基本操作技能。     

外科进修医生手术室护理技能岗前培训方法探讨

目的 探讨提高外科进修医生手术室护理技能的岗前培训方法.方法 对216名外科进修医生进行岗前培训,制订岗前培训计划,采用现场情景教学法进行集中授课、分组讲授、不同场景操作演示等形式.结果 培训前后进修医生手术护理理论知识、操作技能评分比较,差异有显著性意义(均P＜0.01).结论 对进修医生手术室护理技能采用现场情景教学法进行岗前培训,可激发进修医生的学习兴趣,提高学习效率和教学效果.     

动物疾病模型的建立在腹腔镜技术培训中的应用

目的:研究动物模型的建立在腹腔镜技术培训中的应用。方法:回顾总结来自全国各地基层医院的412名外科医师进行7 d外科腹腔镜技术培训的资料,对比分析培训期间采用活体动物建立疾病模型实体操作前后的技术水平。结果:腹腔镜胆囊切除术培训后优于培训前(P<0.05),腹腔镜穿孔缝合修补速度明显高于培训前(P<0.05)。结论:使用活体动物模型进行外科腹腔镜技术培训可取得理想的培训效果,值得推广。     

外科进修医生手术室护理技能岗前培训方法探讨

目的探讨提高外科进修医生手术室护理技能的岗前培训方法。方法对216名外科进修医生进行岗前培训，制订岗前培训计划，采用现场情景教学法进行集中授课、分组讲授、不同场景操作演示等形式。结果培训前后进修医生手术护理理论知识、操作技能评分比较，差异有显著性意义（均P〈0．01）。结论对进修医生手术室护理技能采用现场情莆教学法进行岗前培训，可激发进修医生的学习兴趣，提高学习效率和教学效果。     

腹腔镜模拟培训在外科住院医师规范化培训中的应用

目的:探讨腹腔镜模拟训练在外科住院医师规范化培训中的应用效果。方法:选取2018年12月至2019年11月进行腹腔镜模拟培训的外科住培医师57人次，共举办三期培训班。培训内容包括在腹腔镜模拟器下缝合、打结、剪纸环、拾豆转移等项目，分别测试外科住培医师在三期腹腔镜培训后上述4项技能的完成效果。结果:三期腹腔镜模拟培训班均顺利完成，达到预定的培训目标。培训前后住院医师完成缝合、打结、剪纸环、拾豆转移4项技能的时间少于培训前，差异均有统计学意义(P<0.05)。结论:规范化的腹腔镜模拟培训符合腹腔镜手术的特点，可提高外科住培医师的腹腔镜培训效果，值得推广。     

腹腔镜模拟训练系统用于腹腔镜手术基本技能训练的研究

目的:总结腹腔镜模拟训练系统对不同操作组腹腔镜手术基本技能的提高情况。方法:本科实习生组、研究生无腹腔镜操作经验组、本院进修医师无腹腔镜操作经验组,分别使用腹腔镜模拟训练系统练习镜下夹取黄豆、缝合及器械打结技术,2周后进行统计学分析。结果:操作训练前,本科实习生夹取黄豆、缝合技术及器械打结技术明显不如本院研究生及进修医师(P<0.05),经过2周训练,较简单的技能操作如夹取黄豆和研究生及进修医师无统计学差异(P>0.05),较复杂的技能操作如缝合技术、绕线打结练习训练前、后和本院研究生及进修医师相比差异有统计学意义(P<0.05);但是3组人员训练后与训练前相比,腹腔镜的基本技能操作均显著提高(P<0.05)。结论:腹腔镜模拟训练系统能提高腹腔镜手术操作者的基本技能,值得推广。     

规范化岗前培训的实践与体会

培训新职工是医院人事部门的常态工作,通过培训,医院可以吸收一批有活力、有能力、有素质的新生力量,打造青年精英团队,共同开创医院医疗卫生事业的美好未来,如何让新职工尽快了解医院的规范标准及文化,迅速适应新环境、新岗位的要求,做好岗前培训是非常重要的.本文介绍我院开展新职工岗前培训的实践与体会,认为从培训的计划、实施及效果评价等方面进行规范的培训收到了很好的效果.     

护理实习生岗前培训的调查与实施

目的切实开展护生岗前培训,加强质量控制,提高教学效果。方法培训前调研护生对培训的需求,有针对性地安排培训内容,并制订护理实习生岗前培训手册供全院护生参考。结果 99.3%的护生对培训满意;99.7%的护生认为岗前培训手册帮助非常大;与培训前比较,护生岗前培训知识掌握程度显著提高(P<0.01);岗前培训考试不合格率显著低于往届护生(P<0.05)。结论在全面调查评估的基础上开展规范化岗前培训,可提高教学效果。     

整形外科内窥镜技术三步法培训方法的探讨

探讨整形外科内窥镜技术三步法培训的效果。2015年9月至2019年9月, 北京大学第三医院成形外科采取三步法对成形外科进修医师及专科培训医师进行内窥镜技术培训, 通过问卷调查60名[男33名、女27名, 年龄27～43(34.1±3.8)岁]参培医师的培训效果。共收回51份有效问卷, 参加培训学员平均整形外科工作年限(5.7±2.6)年。46名( 90.2%)学员表示培训能明显提升内窥镜理论知识, 45名(88.2%)表示能明显提升内窥镜操作技术, 47名(92.2%)表示能明显增加未来开展内窥镜整形手术的信心。有内窥镜手术经验学员培训效果评分高于无经验学员(P<0.05)。内窥镜技术三步法培训方法有助于提高整形外科医师技术, 培训应合理地增加手术实际操作机会。     

腹腔镜技术在普通外科临床教学中的应用体会

目的:分析腹腔镜技术在普通外科临床教学中的应用价值。方法:选择2016级64名临床专业规培医师作为研究对象,设为实验组,应用腹腔镜技术的教学方法进行教学,另筛选出2016级64名临床专业规培医师作为对照研究对象,设为对照组,应用传统教学方法进行教学,对比两种教学方法的应用效果。结果:实验组医师培训后理论知识考核成绩与临床技能综合水平考核成绩均高于对照组,差异有统计学意义(P0.05);对照组教学满意度为82.8%,实验组为95.3%,实验组高于对照组,差异有统计学意义(P0.05)。结论:腹腔镜技术在普通外科临床教学中具有较高的应用价值,有助于提升临床专业规培医师的理论知识掌握程度、临床技能综合水平及对教学方法的满意度,值得推行。     

Training for doctors and nurses to deal with bereaved relatives after a sudden death: evaluation of the European Donor Hospital Education Programme (EDHEP) in Germany

The sudden death of a person is one of the most extreme and painful experiences for the relatives, and doctors require special communication skills to deal adequately with the bereaved. The Dutch European Donor Hospital Education Programme was developed to train doctors and nurses in talking to the bereaved relatives and to make the donation request. In Germany, the one-day workshop has been adapted to the German language, law, and clinical practice. The evaluation data of 75 workshops and experiences of 760 participants (doctors, nurses, and psychologists) are reported. The framework of, methods used, and issues dealt with in the workshop were clearly appreciated by the great majority of the participants. Criticisms and suggestions were directed mainly at the duration of the workshop. One third of the participants pleaded for a 2-day workshop, two thirds for a refresher course half a year later. The main effects reported were that two thirds of the participants rated that relatives could be helped, talked with, and cared for in a better way. The workshop participants also reported that they themselves were better able to cope with the situation and were more inclined to take on the task following the workshop. Finally, the necessities and limits of psychosocial training for doctors and their staff are discussed.     

高职护生临床实习的量化管理

目的 探讨量化管理模式在高职护生临床实习中的应用效果.方法 将95名三年制高职护生随机分为对照组(48名)和观察组(47名).对照组实习期间按常规临床实习方式管理;观察组采用岗前培训、专科培训和带教老师共同拟定专科实习计划、完成量化考核表等一系列量化管理模式进行管理.结果 两组护生出科考评成绩、出科综合能力测评成绩比较...     

护患沟通情景训练在护士岗前培训中的应用

目的探讨护患沟通情景训练在护士岗前培训中的应用效果。方法对2010年招聘的146名新护士开展护患沟通情景训练,即采用理论讲解、志愿者角色扮演、教师讲评的方式进行训练;通过理论测试题、调查问卷评价训练结果。结果新护士训练前后沟通能力测试成绩比较,差异有统计学意义(P<0.01);医护患对新护士沟通能力满意度达84.79%~98.39%。结论情景训练能有效提高新护士沟通能力,形成患者满意、医生满意、科室满意的良好效应。     

Short-term impact of a laparoscopic "mini-residency" experience on postgraduate urologists' practice patterns

BACKGROUND: To assist practicing urologists incorporate laparoscopic urology into their practice, a 5-day mini-residency (M-R) program with a mentor, preceptor, and proctor experience was established at the University of California, Irvine, and we report the initial results. STUDY DESIGN: Thirty-two urologists underwent laparoscopic ablative (n=17) or laparoscopic reconstructive (n=15) training, including inanimate model skills training, animal laboratory, and operating room observation. A questionnaire was mailed 1 to 15 months (mean, 8 months) after their M-R program, and responses were reviewed. RESULTS: A 100% response rate was achieved. The mean M-R participant age was 49 years (range 31 to 70 years). The majority of the participants (72%) had laparoscopic experience during residency training and had performed between 5 and 15 laparoscopic cases before attending the M-R program. Within 8 months after M-R, 26 participants (81%) were practicing laparoscopic surgery. Participants were performing laparoscopic radical nephrectomy (p=0.008), nephroureterectomy (p<0.0005), and pyeloplasty (p=0.008) at substantially higher rates after training. At the same time, fewer of the M-R participants were performing hand-assisted laparoscopic surgery after training (p=0.008) compared with before the M-R. Ninety-two percent of the participants indicated that they would recommend this training program to a colleague. CONCLUSIONS: A 5-day intensive laparoscopic ablative and reconstructive surgery course seems to encourage postgraduate urologists, already familiar with laparoscopy, to successfully expand the scope of their procedures to include more complex laparoscopic techniques such as nephrectomy, nephroureterectomy, and pyeloplasty into their clinical practice.     

National survey of surgeons' attitudes to laparoscopic surgical training in South Africa

AIM: Laparoscopic surgery forms an integral component of modern surgical practice. The perception exists that laparoscopic training in South Africa has been unplanned and under-resourced. This study set out to assess the opinions of surgeons and surgical trainees with regard to the various facets of laparoscopic surgical training. METHODS: A national survey was conducted, using a questionnaire distributed to surgical staff of all academic surgical centres. Multiple variables were assessed, predominantly using the following numerical scoring system: 5--strongly agree; 4--agree; 3--neutral; 2--disagree; 1--strongly disagree. RESULTS: There were 122 respondents: 77 trainees and 45 consultants. The majority strongly agreed that laparoscopic training is essential for local surgical registrars. Current laparoscopic training was assessed as being average. Cholecystectomy, diagnostic laparoscopy, antireflux surgery and appendicectomy were the laparoscopic procedures deemed most important in training. The average number of laparoscopic cholecystectomies respondents thought were required for competency was 24. The major hurdle to training was lack of equipment and equipment shortages, and the majority felt that laparoscopic skills facilities and laparoscopy seminars would optimally augment training. CONCLUSION: Surgeons and trainees in academic units recognise the importance of laparoscopic training, but feel that it is currently not optimal. Consensus exists on appropriate procedures and what the hurdles are to training in our context. This knowledge can be applied to improve laparoscopic surgical training in South Africa.     

以胜任力为导向的新护士岗位准入管理研究

目的探讨以胜任力为导向的新护士岗位准入管理方法,为规范新护士岗位培训提供参考依据和实践指导。方法将2011年的76名新护士设为对照组,采用常规的新护士带教方法进行理论授课、操作考核、临床跟班;2012年的102名新护士设为实验组,采用以胜任力为导向的新护士岗位准入管理方法,即成立研究小组,制定培训方案,实行岗前培训、岗位培训、准入考核、上岗跟踪等系列培训管理模块。结果实行岗位准入管理后,两组新护士独立上岗时间、理论操作成绩、护士执业能力等比较,差异有统计学意义（均P〈0．01）。结论以胜任力为导向的新护士岗位准入管理实现了按岗位需求抓好培训,按岗位胜任落实准入资格,有利于新护士岗位工作能力的提高。     

Effectiveness of a hands-on training course for laparoscopic spine surgery in a porcine model

Background: Although it is widely proposed that surgeons, before introducing a novel laparoscopic technique in man, should practice in an appropriate animal model for acquisition of the necessary technical skills, the effectiveness of those hands-on training courses are rarely documented. Methods: In 1995 we have organized eight hands-on training courses for laparoscopic anterior interbody spine fusion in an in vivo porcine model. A total of 72 colleagues from 50 different centers of 12 countries participated, including orthopedic, trauma, visceral, neuro-, and vascular surgeons. Quality and effectiveness of the course were evaluated by a questionnaire after a 1.5- to 2.5-year period. Results: During this time, 42.2% of the participating centers had applied the new technique successfully in man. Centers which participated in the course with a team that included a skilled laparoscopic surgeon and an orthopedic or trauma surgeon introduced the technique more frequently to clinical practice (57.9%) than those represented by only one participant (30.8%). Moreover, there was a tendency toward a more frequent introduction of the technique to clinical practice in centers associated with university hospitals (57.1% vs. 29.2%), indicating the requirement of a particular infrastructure for this complex interdisciplinary procedure. Almost all participants (98.3%) agreed that for novel surgical techniques requiring advanced technical skills, there should first be training in a large animal model before the technique is applied in man. Conclusions: Complex laparoscopic procedures (i.e., laparoscopic spine surgery) can be successfully learned by in vivo hands-on training courses. We propose that for refinements and modifications of the technique (e.g., the lumboscopic approach), there should also first be training in a large animal model before these are applied in man. Received: 30 July 1997/Accepted: 26 March 1998     

Training opportunities and the role of virtual reality simulation in acquisition of basic laparoscopic skills

BACKGROUND: Within the past decade, there has been increasing interest in simulation-based devices for training and assessment of technical skills, especially for minimally invasive techniques such as laparoscopy. The aim of this study was to investigate the perceptions of senior and junior surgeons to virtual reality simulation within the context of current training opportunities for basic laparoscopic procedures. METHODS: A postal questionnaire was sent to 245 consultants and their corresponding specialist registrar (SpR), detailing laparoscopic surgical practice and their knowledge and use of virtual reality (VR) surgical simulators. RESULTS: One hundred ninety-one (78%) consultants and 103(42%) SpRs returned questionnaires; 16%(10/61) of junior SpRs (year 1-4) had performed more than 50 laparoscopic cholecystectomies to date compared with 76% (32/42) of senior SpRs (year 5-6) (P < 0.001); 90% (55/61) of junior SpRs and 67% (28/42) of senior SpRs were keen to augment their training with VR (P = 0.007); 81% (238/294) of all surgeons agreed that VR has a useful role in the laparoscopic surgical training curriculum. CONCLUSIONS: There is a lack of experience in index laparoscopic cases of junior SpRs, and laparoscopic VR simulation is recognized as a useful mode of practice to acquire technical skills. This should encourage surgical program directors to drive the integration of simulation-based training into the surgical curriculum.     

Survey of change in practice following simulation-based training in crisis management

We investigated the long-term effects on clinical practice of a simulation-based course in anaesthesia crisis management. A questionnaire was posted to all anaesthetists who had attended a course in the preceding year. The response rate was 69% (66/96). The crisis management course was valued highly by respondents, who perceive a change in practice as a result of the training. This change in practice was not limited to the specific clinical events simulated in the course, but applied to a wide range of events and to routine practice. The high rate of subsequent critical events reported in the survey supports the need for training in this area. This survey suggests that simulation-based training in crisis management is an effective form of continuing medical education for anaesthetists.     

The mini-fellowship concept: a six-week focused training program for minimally invasive bariatric surgery

Objective To devise a six-week hands-on training program customized to meet the needs of practicing general surgeons. The aim of this program is to provide the required training experience that will bestow the knowledge and skill necessary to implement a successful practice in laparoscopic bariatric surgery. Methods Ten board-certified/board-eligible practicing general surgeons with no prior hands-on or formal training in laparoscopic bariatric surgery. We report on the participants training experience and the impact that the program had on their subsequent laparoscopic bariatric clinical activity. Results Ten surgeons completed training programs from 9/01 to 3/03. None of the trainees had prior experience in laparoscopic bariatric surgery. Program operative experience averaged 42 cases (range 29–66). Trainees were integrated into all preoperative and postoperative hospital and outpatient care on the service, including workshops and seminars. Seven graduates are in practice performing laparoscopic bariatric surgery and three are implementing new bariatric programs. The active surgeons report performing an average of 101 laparoscopic bariatric procedures (range 18–264) over a mean practice period of 10 months (range 4–16) Conclusion A six-week focused mini-fellowship with hands-on operative and clinical participation enables practicing surgeons to acquire the skill and experience necessary to successfully implement a laparoscopic bariatric surgical practice.